Conjoint bicondylar Hoffa fracture in an adult

Abstract

Conjoint bicondylar Hoffa fracture is an extremely rare injury. Only one case has been reported previously in the pediatric age group. We describe this injury in a 17-year-old male who presented following a fall with direct impact on his semiflexed right knee. Plain radiographs were inadequate to define the exact pattern of injury. Computed tomographic (CT) scans demonstrated the coronal fracture involving both the femoral condyles which were joined by a bridge of intact bone. The patient was treated with open reduction and internal fixation using swashbuckler (modified anterior) approach. Union occurred within 3 months and at final followup (at 18 months) the patient had a good clinical outcome. The possible mechanism of injury is discussed.

Conjoined bicondylar coronal plane fracture of the distal femur associated with incarcerated patella

“…Mounasamy et al ,9 used the transverse approach because of associated patellar fracture and traumatic transverse arthrotomy in his case. Anterior midline approach,4 12 and modified anterior7 11 (swashbuckler) approach are now the standard operating procedure for closed bicondylar coronal plane fracture. In our case, we utilised the anterior midline approach with medial parapatellar arthrotomy as patella was laterally dislocated and found to be irreducible even under anaesthesia.…”

“…Most of the authors used anteroposterior lag screw 4 5 7 8 12. Controversy exists about the number and diameter of the screws used while most authors used 4–5 large-fragment PTCS 3 4 11. Two to multiple screws,9 either cortical screws,8 or small-fragment cannulated screws,6 12 have also been used and described.…”

“…Calmet et al ,4 did not advise immediate postoperative immobilisation and advocated immediate range of motion exercises and weight-bearing at 6 weeks, but other authors agreed on cast immobilisation for 2 weeks followed by gradual range of motion exercises and full weight-bearing at 2–3 months 6 7 10 11. Early knee mobilisation is essential to prevent knee stiffness.…”

Bicondylar Hoffa Fracture Successfully Treated with Headless Compression Screws

“…Most authors recommend open reduction to restore normal condylar anatomy and rigid internal fixation, allowing functional recovery [4–13, 15, 16]. Lag screw fixation is the most accepted method to fix Hoffa fractures.…”

Large Isolated Anterior Osteochondral Fracture of the Medial Femoral Condyle: A Case Report

“…Although isolated types of B3.2 and B3.3 are extremely rare and not extensively studied, few reports of these fractures are available in the orthopedic literature (3)(4)(5)(6). However, to the best of our knowledge, no report is available regarding the isolated anterior osteoarticular fracture of the medial femoral condyle (type B3.1).…”